Why do 97 per cent of whistleblowers fail to win their cases in employment tribunals? Why are they sacked – not for their disclosures of patient safety which is illegal – but under the nebulous title – some other substantial reason (SOSR)? This could be allegations of bullying or saying they cannot get on with colleagues.

But how does a trust gather such information to discredit a doctor? What I have discovered is that NHS trust managers can get a free advice service or an endorsement for actions considered by managers against a Whistleblower from NHS Resolution, an arms length quango from the Department for Health and Social Care.

This ” phone a friend” service would allow the manager to set up a case file under Practitioner Performance Advice without the doctor even knowing this has happened. Effectively the evidence will be later presented at an employment tribunal by highly skilled and expensive lawyers hired by the trust to discredit the unfortunate doctor.

This process has no transparency, no verification with the doctor and there are no public records of what happens in these cases.

The only information that there is such a process is in the annual reports and accounts of NHS Resolution and even that is very sparse.

While there are reams of statistics about the organisation’s public facing work dealing with patients complaints about clinical and non clinical issues which it tries to resolve without going to expensive legal action, the role of practitioner performance advice service gets very little mention.

In the 2024-25 annual report it acknowledges “NHS Resolution’s Practitioner Performance Advice service delivers expert advice, support and interventions on the fair management of concerns about the performance of doctors, dentists and pharmacists.”

How do they judge performance having branded the therapist with a “behaviour” issue at the outset even with untrue claims or without awareness of risks to patients? Only when the formal referral actioned the therapist or doctors may get an opportunity to represent their side of the story BUT if the behaviour analyse are not even clinicians, how would they understand what culture therapist or doctor has been working in.

The PPA service also claims to be very efficient. It says 90% of advice and other case interventions delivered within target timeframe – this was achieved in 2024/25 NHS Resolution annual report and accounts 2024 to 2025 90% of all exclusions/suspensions critically reviewed (where due) – this was within tolerance at 82%, with 155 of 189 exclusions/suspensions reviewed within required timescales.

What it does reveal is that trusts searching to use its services are booming.

The report says: “The service received 1,420 new and reopened requests for advice from healthcare organisations with concerns about the practice of individual practitioners as well as services in 2024/25, representing a 24% increase compared to 2023/24.The open caseload at the end of the financial year stood at 1,149, a 15% increase when compared with the end of 2023/24 .”

It adds: “Requests for assessment and remediation services remained at a high level in 2024/25, with 50 requests for professional support and remediation action plans, 44 requests for behavioural assessments, six requests for clinical performance assessments and four requests for team reviews.”

And it says:” NHS Resolution delivered OARs ( Organised Activity Reports) to 18 secondary care trusts in England, offering follow-up consultations with a Performance Practitioner Advice adviser to each, and finalized reports for primary care trusts, mental health trusts and trusts in Wales and Northern Ireland for delivery in 2025/26″.

On what grounds has this service without transparency or regulation of its advisors been set up and run?Sally Cheshire Chair of the NHSR , and Helen Vernon,CEO, need to explain this.

The only other references are likely to lead to hollow laughs from some of the whistleblowers who lost their jobs at trusts – notably Martyn Pitman at Hampshire Hospitals NHS Trust and Usha Prasad at the now St Georges and Epsom and St Helier Hospitals Trust.

It claims that the whole process is to “develop Compassionate Conversations in relation to performance conversations to support kindness and compassion within the NHS .”

It goes on to say: the aim of the advice includes” Fostering just and learning cultures rather than punitive approaches” and” Ensuring fairness and proportionality in managing performance concerns.”

If there is a lack of transparency how can it be justified as a just culture suitable for learning?

Having covered employment tribunals now in NHS sacking cases the last thing I have seen is any compassionate conversation. Instead the trusts are keen to employ numerous highly paid lawyers to terrify and frighten professional doctors reducing in some cases people to tears – at enormous cost to the taxpayer who foots the bill for their salaries.

So if NHS Resolution is boasting about saving lawyer’s fees in patient complaint cases, it is also responsible for increasing lawyer’s fees – often running to hundreds of thousands of pounds – by advising trusts on how to ruin doctors’ careers when all they have raised is patient safety problems.

If you take this process alongside my previous blog about the role of the General Medical Council and its relationship with the responsible medical officer in the trust- it is no wonder that whistleblowers have little chance of success in the NHS. I now know of senior doctors who are NOT going to report patient safety issues because they fear it will be the end of their careers if they do.

NHSR’s PPA is yet another tool like the unregulated triage by the GMC that can be exploited to bury serious concerns using public funding.

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